Kidney Transplants in Children

Learn how kidney transplants work, different types of transplants, and associated risks. Find out if you might be eligible for transplant and how you’re matched with a donor.

What is a kidney transplant?

A kidney transplant is a surgical procedure used to replace an unhealthy kidney with a healthy one from another person. The kidney may come from a deceased organ donor or from a living donor. Family members or friends who are compatible with your body might also be able to donate one of their kidneys to quicken the process. People who donate a kidney can live healthy lives with the remaining kidney.

What types of kidney transplants are possible?

A person receiving a kidney transplant typically receives one kidney, but, in rare situations, a patient will receive both of a deceased donor’s kidneys. Typically, when a kidney is transplanted into someone’s body, the surgeon will leave the diseased kidneys in place and implant the new kidney in the lower front abdomen.

A kidney transplant can be known as “preemptive” or “early” depending on when it is performed. A preemptive transplant is when someone gets a transplant before they need to start dialysis, while an early transplant is when someone receives a transplant after their kidneys have failed and they have spent some time on dialysis. Some research shows that getting a preemptive or early transplant can lead to better long-term health.

How are recipients matched with healthy donor kidneys?

If a family member or friend wants to donate a kidney, that person will need a health exam to test whether the kidney is a good match and that the donated organ will be accepted, not rejected, by your body’s immune system. In order to correctly match someone else’s kidney with your body, three factors are taken into consideration:

• Blood type: Your blood type must be compatible with your donor’s.
• Human leukocyte antigens: These antigens help your immune system tell the difference between your own body’s tissues and foreign substances, and must match your donor’s.
• Cross-matching antigens: This is a lab test performed in which a lab technician mixes a small sample of your blood with a sample of the donor’s blood to see if a reaction takes place. If no reaction occurs, the transplant can proceed.

If you do not have a friend or family member who can donate a compatible kidney, your doctor will submit your name to a national waiting list for a kidney from a deceased donor at the United Network for Organ Sharing (UNOS). When UNOS officially adds you to the waiting list, UNOS will notify you and your transplant team. UNOS will also allow you to register with multiple transplant centers to increase your chances of receiving a kidney. Each transplant center usually requires a separate medical evaluation.

How long is the waiting period?

UNOS normally gives preference to people who have been on the waiting list the longest. However, other factors—such as your age, where you live, and your blood type—can make your wait longer or shorter. Wait times can range from a few months to several years.

If you have a living donor, you do not need to be placed on the waiting list and can schedule the surgery when it is convenient for you and your donor.

What are the risks of kidney transplants?

As with any surgery, complications can occur. Some complications may include:

• Bleeding
• Infection
• Leakage of urine or blockage of urine in the ureter
• Blockage of the blood vessels to the new kidney
• Lack of function of the new kidney at first
• Rejection of new kidney if your immune system thinks it is a threat. For a transplanted organ to survive in its new body, you must take medications so that your immune system will accept the new kidney and not attack it as a foreign object.

It is important to follow the treatment plan your doctor will give you for before and after the surgery.

Depending on your specific medical condition, you may be prone to other risks, so be sure to discuss any questions and concerns with your doctor and your transplant team before you undergo the procedure.